Provider Demographics
NPI:1609930833
Name:HADDAD, ANTOINE G (MD)
Entity Type:Individual
Prefix:
First Name:ANTOINE
Middle Name:G
Last Name:HADDAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BROOKLINE PL
Mailing Address - Street 2:APARTMENT # A-606
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4186
Mailing Address - Country:US
Mailing Address - Phone:617-335-3538
Mailing Address - Fax:
Practice Address - Street 1:1 BROOKLINE PL
Practice Address - Street 2:APARTMENT # A-606
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-4186
Practice Address - Country:US
Practice Address - Phone:617-335-3538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230485207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine